Medata, the originator of Automated Medical Bill Review has processed over 400 Million procedures over the last 33 years - that is well over 150 million bills in just 10 years.
Our Clients can chose to host the software on their own workstations, servers or via the internet. Medata can host the software on its secure ASP environment. Medata's bill review engine CORE, can review over 8,000 bills per hour without human intervention. Medata Services offers an outsource option that allows clients to mail paper bills directly to service centers for scanning and OCR.
Call 1-800-854-7591 or email sales@medata.com .
Medata’s Adjustor Toolbox application is a web-based, workflow management system designed
to allow users to access bills and perform a variety of functions, including approving a
bill for payment or sending a bill out for external review. Additionally, since Adjustor Toolbox
utilizes a relational database to store all bill review information, it serves as a powerful
reporting tool. Adjustor Toolbox was designed for the claim representative to adjudicate, route,
and easily work provider bills from any location. Through Adjustor Toolbox, the client can
establish, automate and manage its preferred bill review workflow, based upon userdefined
business rules. This robust workflow engine enables the client to determine its
own level of aggressiveness in managing medical costs. Every step of the medical bill
adjudication and payment process can be automated and monitored.
Adjustor Toolbox also facilitates physician and hospital bill reviews during the retrospective
review process. The client would also have the ability to request peer reviews, either
manually or in an automated fashion, based upon defined utilization criteria. The peer
review personnel will receive the billing history, specific Medata utilization reports, and,
if the client uses the imaging functionality, the medical records. Upon completion of the
review, the peer review recommendations will be loaded into the Adjustor Toolbox for the client's
review. Rules can also be set to impact payment decisions for future bills, based on the
peer review.
In addition, Adjustor Toolbox is especially helpful in researching claim history and monitoring
potentially fraudulent practices. Adjustor Toolbox builds on the strengths of our Procedure
Analysis Report (PAR) and Advisor functions by incorporating both into the system.
Together, these functions allow the user to compare a particular bill with bills previously
submitted by all providers. This security-compliant application also provides real time,
on-line management reporting to ensure jurisdiction-related on-time processing.